Transportation Troubles and Your Health: All About Medicaid and Patients Who Need NEMT

Do you know that transportation to and from medical visits may be covered by your state Medicaid insurance? It’s true. Medicaid beneficiaries may be able to call for a free, non-emergency ride to a doctor appointment, to a dialysis treatment or to see a mental health professional. Some Medicaid patients can use NEMT to attend prenatal appointments. Some use non-emergency transport, paid for by Medicaid, to receive therapy services and treatment for numerous chronic conditions. In fact, readily available NEMT transportation may be helping more Americans stay healthy than ever before.

Who uses NEMT services

Although scant national data is available, The Henry J. Kaiser Family Foundation notes that non-emergency medical transportation, more commonly called NEMT, is regularly used by thousands of Medicaid patients from coast to coast to avail themselves of preventative care services, substance abuse treatment, physical and occupational therapy, physiological rehabilitation and day care for adults. Persons who use NEMT transportation range from low-income families to senior citizens. The primary users of NEMT may be economically disadvantaged individuals and disabled persons who have no transportation of their own. The fact that NEMT services can be paid for by Medicaid may be increasing the health and longevity of the very young and the elderly, as well.

The Kaiser Foundation explains that nearly 4 million Americans put off or even miss crucial medical appointments every year due to lack of transportation. The foundation also describes a study with results that clearly show how non-emergency medical transport is a cost-effective way for Americans to manage at least a dozen different chronic medical conditions, including but not limited to asthma, diabetes and cardiac disease. NEMT may be used by low-income moms-to-be to get back and forth to all important prenatal appointments. Another similar study proved that grown adults without proper transportation options tend to suffer from more chronic conditions than persons with a sure ride to and from medical visits. According to the Kaiser Foundation, Medicaid covered non-emergency medical transportation services are generally quite cost effective. Here’s what a Transportation Research Board Analysis had to say about NEMT services:

“A strong case can be made that improved access to NEMT for transportation disadvantaged persons is cost-effective in terms of better health care. In some cases, this cost-effectiveness translates directly into decreases in health care costs that exceed the added transportation costs. In other cases, longer life expectancy or improved quality of life for those suffering from the studied conditions justifies the added costs of improved access to NEMT cost-effectiveness.”

How to get a ride

First, consult with your state Medicaid office to ensure you are eligible for services. Expect to be required to prove your income as well as your inability to attend medical appointments any other reasonable way. Once your Medicaid worker has this information in hand, they will be able to tell you how to set up an NEMT ride for yourself, or they may schedule rides on your behalf.

The United States government Medicaid website explains that an NEMT ride may be provided via taxicab, sedan, van or public transportation. NEMT might even involve a subway or a local train. It all depends on the rules of the individual state in which medical rides are authorized. Persons wishing to use NEMT are advised to reserve their ride well in advance of their appointment and be remember to cancel the ride in a timely fashion if any medical appointment is rescheduled. It is worth noting that authorized transportation companies are not allowed to drive Medicaid patients anywhere else and may not make unscheduled stops along the way. To do so would endanger their license to drive for Medicaid patients. Patients who continually forget to be ready for their ride or who neglect to cancel rides before the last minute may find themselves excluded from the Medicaid ride programs.

NEMT is not for urgent care

If you are suffering from shortness of breath, severe chest pain, or bleeding that won’t stop, you need an ambulance, not a NEMT ride. Likewise, if you are experiencing symptoms of head trauma, a super high fever or a headache that gets worse and won’t go away. Severe and unrelenting abdominal pain may be signs that something is seriously wrong and requires a visit to an emergency room or quick care facility without delay.

For persons with certain chronic medical conditions and little or no reliable transportation, NEMT services paid for by Medicaid can be a real life improvement.

Caitlin Parry works in the health care industry and shares some tips and insights with the outside world through her articles. She hopes her articles will be useful to someone out there on the world wide web!